Learning Objective #1: Describe the benefits of utilizing qualitative research as a basis for nursing interventions with vulnerable populations

Learning Objective #2: Analyze how a community health nursing intervention benefits a vulnerable population and the community

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Women who abuse substances are a vulnerable population. A myriad of complex physical, psychosocial and cultural factors places them at risk for poor health. Clients of Women's Residential Addictions Program (WRAP) present with histories that may include psychological and/or physical abuse; mental illness; homelessness; generational poverty; criminal records; estrangement from families; loss of custody of children; no high school diploma; and unemployment. In 2001 nurse researchers from the Department of Nursing and Health Professions of Northern Kentucky University undertook a multi-stage project to improve health care behaviors of the clients of WRAP. The first stage of the project involved a qualitative study to determine how the women perceive and meet health care needs. Results of the qualitative study provided the framework for a model of health care delivery aimed at meeting the needs of the women and improving their health care behaviors. Central to the model is a BSN-prepared registered nurse who triages health care needs at an on-site clinic, refers the women to appropriate health care resources, and provides health education. A one year pilot study of the model was conducted in 2004 at WRAP. All identified outcomes related to services were met or exceeded. One hundred fifty-two of the 160 clients who went through WRAP utilized the nurse's services at the mini-clinic and all clients participated in health education activities. Emergency Room visits decreased by 67%; all ER visits were appropriate. Furthermore, the pilot study group exhibited tendencies toward greater self-efficacy, less contribution of health locus of control to chance and to powerful others, and improved health knowledge versus the comparison group. The Health from the Heart model provides much needed services to a vulnerable population resulting in improved health care behaviors and more efficient utilization of the health care system.